Lewisham Children & Family Centre

Family Practitioner Service

Year 1 – 2021 to 2022

Summary of The Family Practitioner Service Year 1 Review

The Family Practitioner Service (FPS) is a newly commissioned service within Early Years Alliance (EYA) in Lewisham Children and Family Centres (LCFC) for 2021-2022. It is part of the London Borough of Lewisham’s reconfigured Early Intervention response and replaces the previous targeted family support service within LCFC.

In early 2021, the Commissioning Team asked Early Years Alliance to reshape their existing family support offer to work at a lower level than previously, to be positioned below the level of support provided by the L A through the newly formed Family Thrive team as part of the tiered approach of the borough to family support.​ 

 The reshaped offer was designed by EYA and approved by the LA Commissioners. As a result, after a period of restructure and recruitment, EYA fully launched the new Family Practitioner Service in July 2021. ​

 The new service sits within the I-Thrive Framework at the ‘Getting Advice and Getting Help’ stages FPS provides regular 1:1 support to families facing difficult periods and challenges in their lives. The team work in partnership with families and a range of professionals to provide focused support for the whole family, intervening as early as possible and preventing escalation to more intense and specialist services.

The service uses a 6-8 week intervention model, using the Family Star Early Years as a key tool for assessing, evidencing, and measuring the outcomes of this work. The new service is also measured by the LA in terms of number of referrals received and accepted, and tracks quarterly the number of cases at each stage of the 6-8 week model.

Family Star is a useful tool for all stakeholder.. Families, Practitioners, Funders and Commissioners.

The Star is a holistic tool – it is visual, parent friendly, acknowledges strengths and addresses barriers to engagement.

The scales on the Star represent a Theory of Change rather than a score out of 5 or how ‘good’ you are at a particular aspect of parenting.

Family Star is part of a suite of outcomes tools. It is an evidence based holistic tool and provides a baseline and regular review points to measure change across all aspects of parenting and family life. The action plan agreed between the Family Practitioner and the parent forms the basis of the intervention. Action Plans are SMART and represent small, manageable steps toward an agreed goal that gives positive outcomes for the family and this prevents problems getting worse.

Part of the launch of the service involved information sheets being sent to key partners, followed by presentations via Zoom or Teams to key teams such as health visitors, Family Thrive and Children’s Social Care, in order to ensure that referrals into the new service took account of the change of level.

The review took place between November 2021 to April 2022 during which Impact Matters CIC conducted interviews with parents, the staff team and managers of the service.

Aims of the Year 1 Review

Reflect on the new service and how it is working – what works well and what could be improved.

Gather and present feedback from families about the benefits of the service for children and parents.

Showcase the work of the team – highlighting good the work carried out and build on experience.

Provide a visual and engaging resource to showcase the service and share with stakeholders and commissioners.

Methods: Feedback from Families

Seven families who had completed their support plan with The Family Practitioner Service were identified by practitioners to participate in the review. The families gave their permission to be contacted by Impact Matters and this was facilitated by the family practitioner.

Each family was met individually: 4 families were met face to face in local venues: 2 in a LCFC Children’s Centre, 1 in a local park and 1 in a community café. 2 families were ’met’ on Zoom and 1 parent on the phone.

Feedback was gathered through informal interviews with parents, following a set of guiding questions. This method enables respondents to talk in depth about their experience using their own words. It gives the opportunity to gain deeper understanding and also enables the researcher to ask for clarification.

The feedback was audio recorded with the parents’ permission and transcribed by Impact Matters.

 

 

'The practitioner was reliable and consistent - doing what they said they would do and letting the parent know if it couldn't be done'.

 

 

'They really listened - and showed that they had heard me'.

 

 

'They showed warmth, empathy and understanding – were non-judgemental and cared about my family'.

 

 

'Pace – they kept the pace of support going, and didn't allow things to drift'.

 

 

'They treated me as an important human being'.

 

 

'They were clear about what the service could and couldn’t provide'.

Focus of the Interviews with Parents

  • The benefits of the support for parents and child or children – bearing in mind the short time span of the support offered
  • What has changed as a result of the support / what would have happened if the support had not been available
  • How the service links in with other agencies where relevant
  • Are outcomes sustainable

What kind of issues have families had support with?

  • Immediate practical needs – linking to local services such as food banks, age appropriate clothes and toys for families with limited financial resources, supporting families to access doctors and dentists and other relevant medical support, providing information and advice about the borough’s services
  • Supporting families to access Children’s Centres and other local services, particularly when isolated and/or new to the borough, including health services, SEND support, nursery and school, help accessing ESOL classes and interpretation services for families with limited English
  • Regular 1:1 support to the family early to prevent problems escalating to more specialist services (for example at Family Thrive level). This includes help, advice and signposting for children’s routines and behaviour, communication and developmental milestones
  • Supporting parents to improve mental health and emotional wellbeing; acknowledging the impact this has on both the parent and the child
  • Helping families to navigate systems, and services to meet their needs, including support with appointments, form-filling and online registrations
  • During the Family Practitioner interventions if needs are identified for any of our targeted parenting or domestic abuse programs then we can support the referral process

Skills and Qualities of a Practitioner – Parent Reflection

All seven families interviewed spoke very highly of the skills and qualities of the practitioners who supported them and greatly valued the practical and emotional support they received. They described how the support benefited both themselves and their child/children.

As part of the review, we asked parents to comment on the ‘magic ingredients’ that make up their successful support process: we were struck by how all the families commented on the qualities of the worker and the relationship and trust that was developed as a prerequisite for support.

To be treated as an important human being

Warmth, Empathy and Understanding – being non-judgemental and caring about the family

For the practitioner to be reliable and consistent – doing what you say you will do and letting the parent know if it can’t be done

Clarity about what she could do and what she couldn’t do (in terms of what the service can provide)

Pace – keeping the pace of support going, not allowing things to drift

Encouraging the parent to keep the pace going to move things on from their side

Really listening – and showing that you have heard

Giving families hope and a plan

Summary of Outcomes – Family Snapshots

The following snapshots highlight the range of support families have received in their own words, alongside a summary of their Family Star outcomes. You can view each families’ star outcomes by clicking the purple star to see how the service has supported the parent to change. You can read each families’ case study by clicking the button.

 

Click on a Star to view

Click on Case Study to read

Read Case Study 1
Read Case Study 2
Read Case Study 3
Read Case Study 4
Read Case Study 5
Read Case Study 6
Read Case Study 7

Reflections from the Family Practitioners Service team

The four family practitioners and a manager attended a two hour focus group on Zoom.

Year 1 of the new Family Practitioner model has taken place with a background of ongoing covid restrictions as well as being a newly configured service – for example with the team working from home and restrictions on home visits. Covid restrictions have affected all areas of work within the Children’s Centres and more widely across service partnerships – this should be kept in mind when considering the findings below.

At the time of writing the Year 1 review covid restrictions have been lifted nationally. At the same time concern around high rates of Covid infection in the community remains. LCFC are in the process of reviewing and planning services for the coming year in the light of these issues. This means Year 2 may look quite different to Year 1.

Focus of interviews with managers / focus group with practitioners

  • To provide context and reflect on how the new contract has worked over the year
  • To acknowledge the subtleties of the services
  • Has the level of support identified at referral stage been appropriate for the service
  • Whether 6 weeks is a reasonable amount of time to effect change
  • Linking in with other agencies and services

Reflecting on the new Family Practitioner Service

A supportive team

The Family Practitioner team are a newly formed team. Three members of the team are new to both Early Years Alliance and Lewisham Children and Family Centres and were recruited within Year 1 for the Family Practitioner Service. One team member has been with both EYA and LCFC for some years.

All the staff agreed that they have developed a supportive team who value each other during year one. The managers ensure there are regular meet ups, team meetings, supervision etc and the experienced co-worker makes sure she checks in with members of the team each week to offer support and advice. This has been very valuable particularly as the team are working from home which otherwise could have been challenging and isolating.

Working from Home

The team have been working from home and organising their own work due to covid restrictions in place across LCFC. They have been contacting families by telephone, online via Zoom and meeting face to face in the children centres and in the community.

This has been very productive in terms of getting work completed and lack of distraction, however there are also challenges. ‘It is difficult to cut off and put boundaries around the hours you are doing so whilst there are good things, it’s so easy to say I’m just going to finish this and get it done’.

At the moment there are no home visits due to covid restrictions but going forward these will be resumed once the appropriate training, support and risk assessments have been reviewed and are in place.  The team agree that it will be helpful to have at least one home visit with a family as this aids understanding of the family circumstances and will also help with the difficulties of finding appropriate meeting places in the community particularly with regard to privacy.

Outcomes for families

The feedback from families demonstrates the extremely valuable and effective work of the Family Practitioners and the recorded Family Star outcomes show the progress they have made in the short period of time allocated within the new model.

Practitioners discussed what makes a successful engagement with a family within the framework of the new model. There was a high level of congruence between the practitioners perspective and the families who were interviewed.

Magic Ingredients of a Successful Period of Support

Building Trust

Being warm / human

Talking with families not at them

Language – ‘working together’ rather than ‘I am supporting you’

Clarity: Being clear about what you can do and can’t do e.g. housing

Good communication felt part of the journey and I wasn’t dragging him along

Practitioner being active and proactive / following up on things that are taking time

Parent being active and proactive / engaged

Partnership – sharing the process with families to build in sustainable outcomes, e.g. sharing a map of nurseries and doing it together online in real time

Reassurance

Problem solving  approach and sharing this with families

Looking to the future when the worker is no longer around

 

’When everything fits into place it’s like an adrenaline rush - it’s just amazing, everything works and it’s a success and you can achieve so much. That’s a brilliant part of the job. But on the other side it can be extremely frustrating and that is quite hard, it’s hard to get used to and say ok just relax you can’t do that right now’

 

‘I would say the balance between the professional and the friendly balance. Providing that warmth Promoting their independence and empowering them and being professional but also being a shoulder to cry on for some of these families. Mum needs a lot of emotional support; the weekly calls are really valuable and checking in with her’.

 

‘Really listening – no one has really heard them’.

 

'Time management. Building up knowledge and sharing resources e.g. a new charity that can do something for our families’.

 

‘Each family is really different – when you call someone for the first time you have no idea what they are going to be like’.

Family Star Early Years – Practioner Reflection

Practitioners find Family Star Early Years useful and family friendly, bringing a shared framework to the support and helping to structure conversations. Reflecting with parents about how much has changed over the period of support is also very valuable.

 

‘I think it’s great – the layout of it’.

 

‘It’s a really good structure for the conversation, it goes into different areas which you might not cover otherwise, you might miss something if it wasn’t structured like this. It’s then very useful for making the actions with the parent’.

 

‘The whole visual and being able to show them the second star and the improvement … how things have changed is great. It can take a bit of time for families to understand, especially if you are working with families with little or no English and if you are doing it via an interpreter that can be difficult’.

 

‘A nice reflection tool for the parents. It’s a nice tool for the parents when you say the journey of change and shows we are working together and for parents to see what we’ve done together’.

 

’Once they understand it, it makes them think about home life and the children, it breaks things down into different areas of our lives’.

6 Week Model of Support

The experience of the new service shows that whilst there are families where support has been closed within 6 weeks and meaningful outcomes have been achieved, for some families this can be a very short period of time to engage and effect sustainable change.

There are many elements to the 1 to 1 support process and the practitioner is not in control of them all and  this  can make a 6 week model difficult to achieve:

Building Trust: both practitioners and parents have said that relationship building and developing trust is an integral part of the process of support, ‘without this it’s hard to get anything done’. The model incorporates an additional week at the beginning to start the engagement with a family. However initial contact with a family can take longer than this. The parent can be ambivalent or unsure, on the one hand wanting and needing support but on the other hand hard to contact. There may be a gap between the family’s perception of the support they require and the referral. It can take time to establish this with a family and map out the support.

Level of support required for the family: the 6-week model is predicated on families needing a lower level of support – below the threshold for targeted support from the local authority’s newly formed Family Thrive Team. However referrals are not always appropriate for this level of support. Sometimes this is established at the start of the referral pathway, alternatively it can become apparent later in the support process – families can open up about deeper or more sensitive issues further into the support once trust and confidence has been established.

Linking in with other agencies and services; it can take time for families to be linked into other services that they need to access, these timescales are outside the practitioners control.

Whilst there are often mitigating circumstances why cases need to remain open for longer,  practitioners and families both acknowledged that having a timescale  is helpful as it helps to keep up the pace of the support and avoid drift.

Conclusions and Next Steps

The Review of Year 1 of the Family Practitioner service has highlighted the benefits and outcomes of the service for families. Families themselves and practitioners have identified the magic ingredients of successful and effective practice, and clearly the service is both valued and needed.

Part of the reflection at the end of the year suggests that there is a need for a mix of both the more targeted level of support as well as the lower level response currently offered by the service.

Going forward into Year 2 therefore, LCFC are proposing to incorporate more flexibility around  the threshold for family support from FPS and also to extend the timescale to an 8 – 10 week model for families.

This takes into account the needs of families, the skills of the team and the additional services surrounding the  Family Practitioner Service (eg LCFC Domestic Abuse Service and Parenting programmes). It will enable the FPS to work at different levels as appropriate to the referral and needs of the family.  LCFC will also further explore the referral pathway for families to establish the difference between the original reason for referral and the support actually received once the team have carried out their holistic assessment with the family.

Translate with Google Translate
Skip to content